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膝关节整体卸载支具的运动学研究

Kinematic study of the overall unloading brace for the knee.

作者信息

Guo Luqi, Luo Ye, Zhou Lan, Zhang Ziyan, Zhao Yaqi, Li Jixin, Wu Danni, Wang Shaobai

机构信息

School of Exercise and Health, Shanghai University of Sport, Shanghai, China.

Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China.

出版信息

Heliyon. 2023 Jan 21;9(2):e13116. doi: 10.1016/j.heliyon.2023.e13116. eCollection 2023 Feb.

Abstract

OBJECTIVE

Traditional knee braces unloading forces primarily from a single compartment are insufficient for patients with knee injuries or knee osteoarthritis (KOA) involving multiple compartments. We investigated how knee kinematics were altered by an overall unloading brace (OUB) designed to unload both the medial and lateral tibiofemoral (TF) compartments simultaneously during dynamic movement.

METHODS

Gait analysis was performed on 32 adults with normal knee alignment and no history of knee disease. Three-dimensional (3D) knee kinematic data collected during treadmill walking (3 km/h) and jogging (5 km/h) with an optical motion capture system were compared with versus without the OUB.

RESULTS

In the stance phase, wearing the OUB, versus not wearing it, increased the proximal-distal translational range of motion (ROM) of the knee by 4.04 mm (Effect size, ES = 0.97) during walking and by 3.43 mm (ES = 0.97) during jogging, decreased abduction-adduction rotational ROM by 3.09°(ES = 1.05) during walking and by 2.88°(ES = 1.50) during jogging, and decreased internal-external rotation by 2.14°(ES = 0.81) during walking and by 4.66°(ES = 1.61) during jogging. In the swing phase, the OUB increased proximal-distal translational ROM by 12.64 mm (ES = 1.31) during walking and by 9.23 mm (ES = 0.92) during jogging, decreased abduction-adduction rotational ROM by 2.83°(ES = 0.54) during walking and by 3.37°(ES = 0.67) during jogging, and decreased internal-external rotational ROM by 2.71°(ES = 0.68) during jogging.

CONCLUSIONS

OUB use increased proximal-distal translation while reducing abduction-adduction rotation. This effect may increase the joint gap of the tibiofemoral joint, thereby reducing joint stress, and may contribute to disease rehabilitation in the knee of clinical orthopedics, rehabilitation, and sports medicine fields. However, additional studies are needed to assess the range of possible clinical and prophylactic benefits of OUB.

摘要

目的

传统的单室卸载膝关节支具对于涉及多室的膝关节损伤或膝关节骨关节炎(KOA)患者来说是不够的。我们研究了一种整体卸载支具(OUB)在动态运动过程中同时卸载内侧和外侧胫股(TF)关节室时如何改变膝关节运动学。

方法

对32名膝关节排列正常且无膝关节疾病史的成年人进行步态分析。使用光学运动捕捉系统收集在跑步机上行走(3公里/小时)和慢跑(5公里/小时)时佩戴和不佩戴OUB的三维(3D)膝关节运动学数据,并进行比较。

结果

在站立期,佩戴OUB与不佩戴相比,行走时膝关节的近远侧平移运动范围(ROM)增加4.04毫米(效应大小,ES = 0.97),慢跑时增加3.43毫米(ES = 0.97);行走时外展-内收旋转ROM减少3.09°(ES = 1.05),慢跑时减少2.88°(ES = 1.50);行走时内外旋转减少2.14°(ES = 0.81),慢跑时减少4.66°(ES = 1.61)。在摆动期,佩戴OUB行走时近远侧平移ROM增加12.64毫米(ES = 1.31),慢跑时增加9.23毫米(ES = 0.92);行走时外展-内收旋转ROM减少2.83°(ES = 0.54),慢跑时减少3.37°(ES = 0.67);慢跑时内外旋转ROM减少2.71°(ES = 0.68)。

结论

使用OUB增加了近远侧平移,同时减少了外展-内收旋转。这种效果可能会增加胫股关节的关节间隙,从而减轻关节压力,可能有助于临床骨科、康复和运动医学领域膝关节疾病的康复。然而,需要进一步的研究来评估OUB可能的临床和预防益处的范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e02/9898298/de8f7f4bbca1/gr1.jpg

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